Trust investment application form

Transcription

1 Octopus AIM Inheritance Tax Service Trust investment application form How to complete this form Please read the current Octopus AIM Inheritance Tax Service brochure. Write in BLOCK CAPITALS and use BLACK ink. Make sure you answer all questions marked with an asterisk (*). Leave blank any boxes that don t apply to you. Don t forget to include your cheque/banker s draft. Send your completed form (with payment) to: Octopus Investments Limited PO Box Chelmsford CM99 2BU

2 Section 1 About the trust * Name of trust * Legal Entity Identifier (LEI) * Date of formation DD MM YYYY * Country of formation * Address for correspondence * Title (Mr/Mrs/Miss/Ms/Other) * Country Postcode Primary trustee Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM * First name(s) * Last name * Date of birth DD MM YYYY * Country of birth * Country(ies) of citizenship * Telephone numbers Country code Telephone number Primary: Secondary: * address * Address * Country Postcode * Information from Octopus Octopus may occasionally send you information that we believe to be of interest to you, e.g. newsletters. If you would not like to receive such information, please tick the box. Page 2 of 10

3 Additional trustees Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Trustee 2 Telephone numbers Country code Telephone number Address Primary: Secondary: Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM Title (Mr/Mrs/Miss/Ms/Other) Country Postcode First name(s) Trustee 3 Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Telephone numbers Country code Telephone number Primary: Address Secondary: Country Postcode Page 3 of 10

4 Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Trustee 4 Telephone numbers Country code Telephone number Address Primary: Secondary: Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM Country Postcode Indicate the name of any Controlling Person(s) of the entity other than the trustees listed above In the case of trusts this may include, but is not limited to: settlors, trustees and any named beneficiaries. Section 2 About the beneficiaries Please insert the details of any individual(s) to be beneficiary of the trust If the beneficiary is not a specific individual and is instead a defined group or class of beneficiaries (for example, the grandchildren of the settlor), please include details here: Beneficiary 1 Beneficiary 2 Address Address Postcode Date of birth DD MM YYYY Postcode Date of birth DD MM YYYY Country of birth Country of birth Country(ies) of citizenship Country(ies) of citizenship Telephone number Telephone number Page 4 of 10

5 Beneficiary 3 Address Postcode Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Beneficiary 4 Address Postcode Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM Telephone number Telephone number Further information on beneficiaries of the trust Section 3 About the investment * How much are you investing? The minimum investment is 25,000 * Cheque/banker s draft or bank transfer (Tick one box only) Cheque/banker s draft Please enclose a cheque from the trust or settlor s account, made payable to Octopus Investments Client Money Account. We do not accept cheques from business accounts, third parties or post-dated cheques. Banker s drafts and building society cheques must specifically mention the trust or settlor s name. Bank transfer Please transfer your investment to the following account after first sending in your completed application form and identification, making sure that you reference the payment with the name of the trust: Sort code: Bank: HSBC Account number: Branch: Holborn Payments need to come from the trust or settlor s account. Section 4 About the adviser/intermediary (to be completed by the adviser/intermediary) * Company * Title (Mr/Mrs/Miss/Ms/Other) * First name(s) If this is the first time we will be paying your company adviser charges, please contact us on to arrange setting up payment details. * Last name * Telephone number * address

6 * Address * Country Postcode * Company FCA number * Adviser FCA number * Are you part of a network/service provider? * Network/service provider FCA number No Section 5 Type of investment * What type of investment is this? Yes please give us the network/service provider name Please read the following text and then complete either 5.1, 5.2 or 5.3. Failure to complete this section correctly could result in delays to the investment. If you have any questions please call us on If you have received financial advice for this investment then this is an advised investment. Please complete section 5.1. If you are not submitting your application through an adviser or intermediary then this is a direct investment. Please complete section 5.2. If this is an execution only investment and you have not received financial advice then this is a non-advised investment. Any commission due will be paid by Octopus. Please complete section 5.3. Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM This is an advised investment Please indicate the level of initial adviser charges and/or ongoing adviser charges agreed. If you have not agreed that Octopus will facilitate charges to your adviser then please indicate Nil. Any initial charge agreed with your adviser is taken from your payment(s) and paid to your adviser before your funds are invested. Initial adviser charge (Tick one box only) Fixed amount OR percentage % If no option is selected from the above no initial adviser charge will be applied. Ongoing adviser charge (Tick one box only) Fixed amount per year OR percentage % The amount or percentage stated above (whichever is relevant) is an annual amount, accrued each day. If you choose to pay on a percentage basis, this will be calculated on the value of your portfolio. We will pay your adviser annually by selling assets from your portfolio. Please go straight to Section 7. Your adviser needs to sign the declaration in Section This is a direct investment. Please complete Section 6. This is a non-advised investment through an intermediary Section 6 Suitability and source of wealth Client suitability questionnaire What s the source of your wealth? Please tell us how you acquired the money you plan to invest, select all that apply. Initial commission % Ongoing commission % Standard terms will apply if left blank. Commission should not exceed our standard terms, otherwise this form may be rejected. Please complete Section 6. Your intermediary needs to sign the declaration in Section 9. Only to be completed if this is a direct or non-advised investment through an intermediary i.e. you have ticked either 5.2 or 5.3, above. Please note that we require the primary trustee to submit a completed client suitability questionnaire before we can process your direct or non-advised application. The questionnaire is available from the Application Forms page of the Document Library at octopusinvestments.com or you can call for a copy. Earned income Ownership in a company Inheritance Gifts Sale of property Investment proceeds Other If other, please specify: (In some cases, further information and documentary evidence may be required.) Page 6 of 10

7 Section 7 About Octopus charges Special instructions Section 8 Tax residency status Part I Tax residency * Please note, if your organisation is a branch you should consider this at the branch level, not at the legal entity level Please refer to the Octopus AIM Inheritance Tax Service brochure for information about Octopus charges. We are legally required to collect information about the tax residency and classifications of each investor which may be shared with HM Revenue & Customs, and may be transferred to the government of another territory in accordance with a relevant agreement. For further information please visit octopusinvestments.com/reportingforms. Is the entity tax resident, or do you complete tax returns on behalf of the entity, in any country other than the UK? No please go straight to Part II. Yes please list the country(ies), other than the UK, in which the entity is resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM Country(ies) Taxpayer Identification Number (TIN) TIN not available Part II All Entities FATCA classification under the UK-US IGA Global Intermediary Identification Number (GIIN) Name of sponsoring entity, if applicable If unable to provide a GIIN, please tick the reason why your organisation does not have a GIIN Please tick to confirm your organisation s FATCA status under the UK-US IGA A TO BE COMPLETED BY FINANCIAL INSTITUTIONS ONLY It is a Financial Institution in an IGA Partner Jurisdiction and has not yet obtained a GIIN It is a Financial Institution in a non-iga Partner Jurisdiction that has not yet applied for a GIIN, but intends to apply for a GIIN It is a Financial Institution in a non-iga Partner Jurisdiction that has applied for, but has yet to receive a GIIN It is an Exempt Beneficial Owner It is a Certified Deemed Compliant Financial Institution It is a Non-Participating Foreign Financial Institution B TO BE COMPLETED BY NON-FINANCIAL INSTITUTIONS ONLY Active Non-Financial Foreign Entity (NFFE) Passive Non-Financial Foreign Entity (NFFE), please complete the relevant Self-Certification Forms for each controlling person. (In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights.) Forms can be downloaded online at octopusinvestments.com/reportingforms Direct Reporting Non-Financial Foreign Entity (NFFE), if sponsored please provide the details of the sponsoring entity: Name: GIIN: Please tick this box to confirm that the sponsoring entity has agreed to act as the sponsoring entity for your organisation. Page 7 of 10

8 Part III All Entities/Branches classification under the Common Reporting Standard Please tick to confirm your organisation s status under the Common Reporting Standard Please tick to confirm your organisation s status under the Common Reporting Standard A TO BE COMPLETED BY FINANCIAL INSTITUTIONS ONLY Financial Institution Investment Entity OR An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution. Please complete the relevant Self-Certification Forms for each controlling person. (In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights.) Forms can be downloaded online at octopusinvestments.com/reportingforms. Other Investment Entity Financial Institution Depository Institution, Custodial Institution or Specified Insurance Company B TO BE COMPLETED BY NON FINANCIAL INSTITUTIONS ONLY Active Non-Financial Entity (NFE) a corporation the stock of which is regularly traded on an established securities market or a corporation which is a related entity of such a corporation. If you have ticked, please provide the name of the established securities market on which the corporation is regularly traded: Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM If you are a Related Entity of a regularly traded corporation, please provide the name of the regularly traded corporation that the Entity above is a Related Entity of: Section 9 Adviser/intermediary declaration Adviser/intermediary signature Active Non-Financial Entity (NFE) a Government Entity or Central Bank Active Non-Financial Entity (NFE) an International Organisation Active Non-Financial Entity (NFE) other than above (for example a start-up NFE or a non-profit NFE) Passive Non-Financial Entity (NFE) please complete the relevant Self-Certification Forms for each controlling person. (In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights.) Forms can be downloaded online at octopusinvestments.com/reportingforms By submitting this form, I AGREE THAT: I have read and understand the Terms of Business for Intermediaries. I agree to be bound by these Terms of Business. As an Appointed Representative, I warrant and represent that my principal also accepts the Terms of Business for Intermediaries. I have made a personal recommendation to the applicant that satisfies the requirements of COBS 9 suitability. (Strike through this bullet point if this is a non-advised investment.) Date signed DD MM YYYY Page 8 of 10

9 Section 10 Applicant declaration To be completed by the trustees named in Section 1, or registered Attorney(s) * Name * Signature * Date signed DD MM YYYY * Name By signing this form I/WE HEREBY DECLARE THAT I/WE: 1. Have read and understand the current Octopus AIM Inheritance Tax Service brochure and the risk factors explained in it. 2. Have read and understand the Terms and Conditions and agree to be bound by them. 3. Have provided accurate information, to the best of my/our knowledge. 4. Have read and understood the Octopus policies regarding best execution, conflicts of interest and gift and benefits, all available at octopusinvestments.com. 5. Consent to Octopus providing information to my/our adviser/intermediary until notified otherwise. 6. Consent to Octopus facilitating any adviser s fees and charges as set out in Section 5. Primary trustee Trustee 2 Trustee 3 Trustee 4 Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM * Signature * Date signed DD MM YYYY Page 9 of 10

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11 Octopus Investments Tax Residency Self-Certification Form for Controlling Person How to complete this form 1 Please complete this form in BLOCK CAPITALS with a black ball point pen. 2 Once completed please send to: Octopus Investments Limited PO Box Chelmsford CM99 2BU

12 Octopus Investments is required by UK law to collect information about the tax residency and tax classification status of its investors. In certain circumstances it may be necessary for us to share this information with HM Revenue and Customs (HMRC), which is also obliged to share relevant information with tax authorities in other jurisdictions. Please note, each Controlling Person should complete a Self-Certification Form. In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights. You can either photocopy this form, download and print an additional copy from octopusinvestments.com/reportingforms or call our Client Relations Team on who will send you one by post. If you have any questions about tax residence or classification, we recommend that you contact your adviser. Section 1 About the Controlling Person Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Telephone numbers Country code Telephone number Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Home: Work: Address Mobile: Country Postcode Please enter the legal name of the relevant entity Account Holder(s) of which you are a Controlling Person Legal name of Entity 1 Legal name of Entity 2 Legal name of Entity 3 Page 12 of 32

13 Type of Controlling Person (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions) Please provide the Controlling Person s status by ticking the appropriate box. Controlling Person of a corporation, a partnership, a pension fund or a charity. Control by ownership Control by other means Senior managing official Controlling Person of a trust. Settlor Trustee Protector Beneficiary Other Entity 1 Entity 2 Entity 3 Controlling Person of a legal arrangement (non-trust). A legal arrangement is any entity which is neither a legal entity (such as a company or partnership) nor a trust. Examples of a legal arrangement include, but are not limited to, unincorporated clubs and associations. Settlor-equivalent Trustee-equivalent Protector-equivalent Beneficiary-equivalent Other-equivalent Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Section 2 Tax Residency status 2.1 Are you tax resident, or do you complete tax returns, in any country other than the UK? No please go straight to Section 3. If your country of birth or country of citizenship is outside of the UK, please send us a certified copy of a valid UK ID, such as a UK driving licence or passport, or a certified letter from HMRC, to confirm your UK tax residency status. Yes please complete the table below. 2.2 Please list the country(ies), other than the UK, in which you are resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Country(ies) Taxpayer Identification Number (TIN) TIN not available Page 13 of 32

14 Section 3 Declaration Investor declaration (To be completed by the Controlling Person named in Section 1,or registered Attorney(s)) Controlling Person name Controlling Person signature I declare that to the best of my knowledge and belief, the information I have provided in this form is true, correct and complete. I understand that the information contained in this form and any information about the Investor and their accounts may be reported to the tax authorities of the country in which these accounts are maintained. They may also be exchanged with tax authorities of another country or countries in which the Controlling Person is a tax resident depending on the Intergovernmental Agreements (IGAs) that are in place. Capacity (Note: If you are not the Controlling Person please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attach a certified copy of the power of attorney.) Date signed DD MM YYYY Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions, please call us on We re always happy to hear from you clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT Issued by Octopus Investments Limited which is authorised and regulated by the Financial Conduct Authority. Registered Office: 33 Holborn, London, EC1N 2HT. Registered in England and Wales No We record telephone calls. Issued November Page 14 of 32 M2-CAM

15 Octopus Investments Tax Residency Self-Certification Form for Controlling Person How to complete this form 1 Please complete this form in BLOCK CAPITALS with a black ball point pen. 2 Once completed please send to: Octopus Investments Limited PO Box Chelmsford CM99 2BU

16 Octopus Investments is required by UK law to collect information about the tax residency and tax classification status of its investors. In certain circumstances it may be necessary for us to share this information with HM Revenue and Customs (HMRC), which is also obliged to share relevant information with tax authorities in other jurisdictions. Please note, each Controlling Person should complete a Self-Certification Form. In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights. You can either photocopy this form, download and print an additional copy from octopusinvestments.com/reportingforms or call our Client Relations Team on who will send you one by post. If you have any questions about tax residence or classification, we recommend that you contact your adviser. Section 1 About the Controlling Person Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Telephone numbers Country code Telephone number Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Home: Work: Address Mobile: Country Postcode Please enter the legal name of the relevant entity Account Holder(s) of which you are a Controlling Person Legal name of Entity 1 Legal name of Entity 2 Legal name of Entity 3 Page 16 of 32

17 Type of Controlling Person (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions) Please provide the Controlling Person s status by ticking the appropriate box. Controlling Person of a corporation, a partnership, a pension fund or a charity. Control by ownership Control by other means Senior managing official Controlling Person of a trust. Settlor Trustee Protector Beneficiary Other Entity 1 Entity 2 Entity 3 Controlling Person of a legal arrangement (non-trust). A legal arrangement is any entity which is neither a legal entity (such as a company or partnership) nor a trust. Examples of a legal arrangement include, but are not limited to, unincorporated clubs and associations. Settlor-equivalent Trustee-equivalent Protector-equivalent Beneficiary-equivalent Other-equivalent Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Section 2 Tax Residency status 2.1 Are you tax resident, or do you complete tax returns, in any country other than the UK? No please go straight to Section 3. If your country of birth or country of citizenship is outside of the UK, please send us a certified copy of a valid UK ID, such as a UK driving licence or passport, or a certified letter from HMRC, to confirm your UK tax residency status. Yes please complete the table below. 2.2 Please list the country(ies), other than the UK, in which you are resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Country(ies) Taxpayer Identification Number (TIN) TIN not available Page 17 of 32

18 Section 3 Declaration Investor declaration (To be completed by the Controlling Person named in Section 1,or registered Attorney(s)) Controlling Person name Controlling Person signature I declare that to the best of my knowledge and belief, the information I have provided in this form is true, correct and complete. I understand that the information contained in this form and any information about the Investor and their accounts may be reported to the tax authorities of the country in which these accounts are maintained. They may also be exchanged with tax authorities of another country or countries in which the Controlling Person is a tax resident depending on the Intergovernmental Agreements (IGAs) that are in place. Capacity (Note: If you are not the Controlling Person please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attach a certified copy of the power of attorney.) Date signed DD MM YYYY Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions, please call us on We re always happy to hear from you clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT Issued by Octopus Investments Limited which is authorised and regulated by the Financial Conduct Authority. Registered Office: 33 Holborn, London, EC1N 2HT. Registered in England and Wales No We record telephone calls. Issued November Page 18 of 32 M2-CAM

19 Octopus Investments Tax Residency Self-Certification Form for Controlling Person How to complete this form 1 Please complete this form in BLOCK CAPITALS with a black ball point pen. 2 Once completed please send to: Octopus Investments Limited PO Box Chelmsford CM99 2BU

20 Octopus Investments is required by UK law to collect information about the tax residency and tax classification status of its investors. In certain circumstances it may be necessary for us to share this information with HM Revenue and Customs (HMRC), which is also obliged to share relevant information with tax authorities in other jurisdictions. Please note, each Controlling Person should complete a Self-Certification Form. In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights. You can either photocopy this form, download and print an additional copy from octopusinvestments.com/reportingforms or call our Client Relations Team on who will send you one by post. If you have any questions about tax residence or classification, we recommend that you contact your adviser. Section 1 About the Controlling Person Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Telephone numbers Country code Telephone number Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Home: Work: Address Mobile: Country Postcode Please enter the legal name of the relevant entity Account Holder(s) of which you are a Controlling Person Legal name of Entity 1 Legal name of Entity 2 Legal name of Entity 3 Page 20 of 32

21 Type of Controlling Person (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions) Please provide the Controlling Person s status by ticking the appropriate box. Controlling Person of a corporation, a partnership, a pension fund or a charity. Control by ownership Control by other means Senior managing official Controlling Person of a trust. Settlor Trustee Protector Beneficiary Other Entity 1 Entity 2 Entity 3 Controlling Person of a legal arrangement (non-trust). A legal arrangement is any entity which is neither a legal entity (such as a company or partnership) nor a trust. Examples of a legal arrangement include, but are not limited to, unincorporated clubs and associations. Settlor-equivalent Trustee-equivalent Protector-equivalent Beneficiary-equivalent Other-equivalent Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Section 2 Tax Residency status 2.1 Are you tax resident, or do you complete tax returns, in any country other than the UK? No please go straight to Section 3. If your country of birth or country of citizenship is outside of the UK, please send us a certified copy of a valid UK ID, such as a UK driving licence or passport, or a certified letter from HMRC, to confirm your UK tax residency status. Yes please complete the table below. 2.2 Please list the country(ies), other than the UK, in which you are resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Country(ies) Taxpayer Identification Number (TIN) TIN not available Page 21 of 32

22 Section 3 Declaration Investor declaration (To be completed by the Controlling Person named in Section 1,or registered Attorney(s)) Controlling Person name Controlling Person signature I declare that to the best of my knowledge and belief, the information I have provided in this form is true, correct and complete. I understand that the information contained in this form and any information about the Investor and their accounts may be reported to the tax authorities of the country in which these accounts are maintained. They may also be exchanged with tax authorities of another country or countries in which the Controlling Person is a tax resident depending on the Intergovernmental Agreements (IGAs) that are in place. Capacity (Note: If you are not the Controlling Person please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attach a certified copy of the power of attorney.) Date signed DD MM YYYY Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions, please call us on We re always happy to hear from you clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT Issued by Octopus Investments Limited which is authorised and regulated by the Financial Conduct Authority. Registered Office: 33 Holborn, London, EC1N 2HT. Registered in England and Wales No We record telephone calls. Issued November Page 22 of 32 M2-CAM

23 Octopus Investments Tax Residency Self-Certification Form for Controlling Person How to complete this form 1 Please complete this form in BLOCK CAPITALS with a black ball point pen. 2 Once completed please send to: Octopus Investments Limited PO Box Chelmsford CM99 2BU

24 Octopus Investments is required by UK law to collect information about the tax residency and tax classification status of its investors. In certain circumstances it may be necessary for us to share this information with HM Revenue and Customs (HMRC), which is also obliged to share relevant information with tax authorities in other jurisdictions. Please note, each Controlling Person should complete a Self-Certification Form. In the case of trusts this may include: settlors, trustees and any named beneficiaries. In the case of companies this may include: owners, managing officials, and any person who owns or controls more than 25% of the capital, profits or voting rights. You can either photocopy this form, download and print an additional copy from octopusinvestments.com/reportingforms or call our Client Relations Team on who will send you one by post. If you have any questions about tax residence or classification, we recommend that you contact your adviser. Section 1 About the Controlling Person Title (Mr/Mrs/Miss/Ms/Other) First name(s) Last name Date of birth DD MM YYYY Country of birth Country(ies) of citizenship Telephone numbers Country code Telephone number Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Home: Work: Address Mobile: Country Postcode Please enter the legal name of the relevant entity Account Holder(s) of which you are a Controlling Person Legal name of Entity 1 Legal name of Entity 2 Legal name of Entity 3 Page 24 of 32

25 Type of Controlling Person (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions) Please provide the Controlling Person s status by ticking the appropriate box. Controlling Person of a corporation, a partnership, a pension fund or a charity. Control by ownership Control by other means Senior managing official Controlling Person of a trust. Settlor Trustee Protector Beneficiary Other Entity 1 Entity 2 Entity 3 Controlling Person of a legal arrangement (non-trust). A legal arrangement is any entity which is neither a legal entity (such as a company or partnership) nor a trust. Examples of a legal arrangement include, but are not limited to, unincorporated clubs and associations. Settlor-equivalent Trustee-equivalent Protector-equivalent Beneficiary-equivalent Other-equivalent Octopus-ops-tax-residency-self-certification-form-for-controlling-person-retail-M2-CAM Section 2 Tax Residency status 2.1 Are you tax resident, or do you complete tax returns, in any country other than the UK? No please go straight to Section 3. If your country of birth or country of citizenship is outside of the UK, please send us a certified copy of a valid UK ID, such as a UK driving licence or passport, or a certified letter from HMRC, to confirm your UK tax residency status. Yes please complete the table below. 2.2 Please list the country(ies), other than the UK, in which you are resident for tax purposes. Please provide the Taxpayer Identification Number (TIN) or functional equivalent for each country(ies), or tick the relevant box if the country does not provide a TIN. Country(ies) Taxpayer Identification Number (TIN) TIN not available Page 25 of 32

26 Section 3 Declaration Investor declaration (To be completed by the Controlling Person named in Section 1,or registered Attorney(s)) Controlling Person name Controlling Person signature I declare that to the best of my knowledge and belief, the information I have provided in this form is true, correct and complete. I understand that the information contained in this form and any information about the Investor and their accounts may be reported to the tax authorities of the country in which these accounts are maintained. They may also be exchanged with tax authorities of another country or countries in which the Controlling Person is a tax resident depending on the Intergovernmental Agreements (IGAs) that are in place. Capacity (Note: If you are not the Controlling Person please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attach a certified copy of the power of attorney.) Date signed DD MM YYYY Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions, please call us on We re always happy to hear from you clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT Issued by Octopus Investments Limited which is authorised and regulated by the Financial Conduct Authority. Registered Office: 33 Holborn, London, EC1N 2HT. Registered in England and Wales No We record telephone calls. Issued November Page 26 of 32 M2-CAM

27 Before sending us your application, please review the quick checklist below to help us process your application as quickly as possible: You have arranged for payment as per Section 3. You have completed Section 5 adviser/intermediary charges. Octopus-IHT-AIM-ITS-trust-application-form-retail-M2-CAM The trustees have answered all questions that apply to the trust. Unless this is a direct investment, your adviser or intermediary has signed and dated where indicated in Section 9. All the trustees have signed the declaration in Section 10. You have enclosed a copy of the trust deed which must be certified by a regulated individual (e.g. financial adviser; solicitor or accountant), along with any relevant Deed of Variation. You have enclosed the necessary verification of identity documentation which must be certified by a regulated individual (see above) for each trustee: An Identity Verification Certificate or one each of the following; a certified copy of identification (your passport or driving licence) plus; a certified copy of proof of address (driving licence, bank statement or recent utility bill (not mobile phone)) The original signature should be on each page of the document (not a photocopy). Once complete please send your completed application form to: Octopus Investments Limited PO Box Chelmsford CM99 2BU What happens next? 1 As soon as we receive your application we will send you an acknowledgement. 2 We will invest your money in a portfolio of qualifying shares. It will usually take up to eight weeks for your money to be fully invested. 3 Once your funds have been invested we will send you regular valuation statements. You can also check your account online through our secure website. Page 27 of 32

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32 Octopus AIM Inheritance Tax Service Got a question? We don t offer financial or tax advice, which is why we always recommend talking to a qualified financial adviser before making any investment decisions. However, if you have any other questions about the Octopus AIM Inheritance Tax Service, please call us on We re always happy to hear from you clientrelations@octopusinvestments.com octopusinvestments.com Octopus Investments, 33 Holborn, London EC1N 2HT Octopus Investments Limited is authorised and regulated by the Financial Conduct Authority. Registered office: 33 Holborn, London EC1N 2HT. Registered in England and Wales No We record calls. M2-CAM